Predicting incomplete cytoreduction in patients with advanced ovarian cancer
PurposeThe most important prognostic factor for survival in ovarian cancer patients is complete cytoreduction. The preoperative prediction of suboptimal cytoreduction, considered as any residual disease at the end of surgery, could prevent futile surgery and morbidity. Here, we aimed to identify mar...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1060006/full |
| _version_ | 1828272020142424064 |
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| author | Eva K. Egger Marie Antonia Buchen Florian Recker Matthias B. Stope Holger Strunk Alexander Mustea Milka Marinova |
| author_facet | Eva K. Egger Marie Antonia Buchen Florian Recker Matthias B. Stope Holger Strunk Alexander Mustea Milka Marinova |
| author_sort | Eva K. Egger |
| collection | DOAJ |
| description | PurposeThe most important prognostic factor for survival in ovarian cancer patients is complete cytoreduction. The preoperative prediction of suboptimal cytoreduction, considered as any residual disease at the end of surgery, could prevent futile surgery and morbidity. Here, we aimed to identify markers in the preoperative abdominal CT scans of an unselected cohort of patients with ovarian cancer that are predictive of incomplete cytoreduction.MethodsThis is a single-institution retrospective analysis of 105 epithelial ovarian cancer (EOC) patients treated with surgical cytoreduction between 2010 and 2020. Twenty-two variables on preoperative abdominal CT scans were compared to the intraoperative macroscopic findings by Fisher’s exact test. Parameters with a significant correlation between intraoperative findings and imaging were analyzed by multivariate binary logistic regression analysis regarding the surgical outcome of complete versus incomplete cytoreduction.ResultsComplete cytoreduction (CC), indicated by the absence of macroscopic residual disease, was achieved in 79 (75.2%) of 105 patients and 46 (63.9%) of 72 International Federation of Gynecology and Obstetrics (FIGO) stage III and IV patients. Twenty patients (19%) were incompletely cytoreduced due to miliary carcinomatosis of the small bowel, and six patients (5.7%) had various locations of residual disease. Thirteen variables showed a significant correlation between imaging and surgical findings. Large-volume ascites, absence of numerically increased small lymph nodes at the mesenteric root, and carcinomatosis of the transverse colon in FIGO stage III and IV patients decreased the rate of CC to 26.7% in the multivariate analysis.ConclusionLarge-volume ascites, the absence of numerically increased small lymph nodes at the mesenteric root, and carcinomatosis of the transverse colon are markers in preoperative CT scans predicting a low chance for complete cytoreduction in unselected ovarian cancer patients in a real-world setting. |
| first_indexed | 2024-04-13T06:00:51Z |
| format | Article |
| id | doaj.art-be1fb597ffd9471a9430ae6c76e9b36e |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T06:00:51Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-be1fb597ffd9471a9430ae6c76e9b36e2022-12-22T02:59:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-12-011210.3389/fonc.2022.10600061060006Predicting incomplete cytoreduction in patients with advanced ovarian cancerEva K. Egger0Marie Antonia Buchen1Florian Recker2Matthias B. Stope3Holger Strunk4Alexander Mustea5Milka Marinova6Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, GermanyDepartment of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, GermanyDepartment of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, GermanyDepartment of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, GermanyMedicine Center Bonn, Medical Care Center, Bonn, GermanyDepartment of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, GermanyDepartment of Nuclear Medicine, University Hospital Bonn, Bonn, GermanyPurposeThe most important prognostic factor for survival in ovarian cancer patients is complete cytoreduction. The preoperative prediction of suboptimal cytoreduction, considered as any residual disease at the end of surgery, could prevent futile surgery and morbidity. Here, we aimed to identify markers in the preoperative abdominal CT scans of an unselected cohort of patients with ovarian cancer that are predictive of incomplete cytoreduction.MethodsThis is a single-institution retrospective analysis of 105 epithelial ovarian cancer (EOC) patients treated with surgical cytoreduction between 2010 and 2020. Twenty-two variables on preoperative abdominal CT scans were compared to the intraoperative macroscopic findings by Fisher’s exact test. Parameters with a significant correlation between intraoperative findings and imaging were analyzed by multivariate binary logistic regression analysis regarding the surgical outcome of complete versus incomplete cytoreduction.ResultsComplete cytoreduction (CC), indicated by the absence of macroscopic residual disease, was achieved in 79 (75.2%) of 105 patients and 46 (63.9%) of 72 International Federation of Gynecology and Obstetrics (FIGO) stage III and IV patients. Twenty patients (19%) were incompletely cytoreduced due to miliary carcinomatosis of the small bowel, and six patients (5.7%) had various locations of residual disease. Thirteen variables showed a significant correlation between imaging and surgical findings. Large-volume ascites, absence of numerically increased small lymph nodes at the mesenteric root, and carcinomatosis of the transverse colon in FIGO stage III and IV patients decreased the rate of CC to 26.7% in the multivariate analysis.ConclusionLarge-volume ascites, the absence of numerically increased small lymph nodes at the mesenteric root, and carcinomatosis of the transverse colon are markers in preoperative CT scans predicting a low chance for complete cytoreduction in unselected ovarian cancer patients in a real-world setting.https://www.frontiersin.org/articles/10.3389/fonc.2022.1060006/fullovarian cancercytoreductionCT scanresidual tumormesenteric lymph nodes |
| spellingShingle | Eva K. Egger Marie Antonia Buchen Florian Recker Matthias B. Stope Holger Strunk Alexander Mustea Milka Marinova Predicting incomplete cytoreduction in patients with advanced ovarian cancer Frontiers in Oncology ovarian cancer cytoreduction CT scan residual tumor mesenteric lymph nodes |
| title | Predicting incomplete cytoreduction in patients with advanced ovarian cancer |
| title_full | Predicting incomplete cytoreduction in patients with advanced ovarian cancer |
| title_fullStr | Predicting incomplete cytoreduction in patients with advanced ovarian cancer |
| title_full_unstemmed | Predicting incomplete cytoreduction in patients with advanced ovarian cancer |
| title_short | Predicting incomplete cytoreduction in patients with advanced ovarian cancer |
| title_sort | predicting incomplete cytoreduction in patients with advanced ovarian cancer |
| topic | ovarian cancer cytoreduction CT scan residual tumor mesenteric lymph nodes |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1060006/full |
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